Is your organisation part of, or affiliated to, any national organisation? If yes please give details*:

What is the catchment area covered by your organisation?*

Briefly describe the project or purpose for which you require a grant*:

How will the project benefit the community or residents of Berkhamsted?*

Is your organisation VAT registered? Yes/No number*:

YesNoOther:

When do you intend to start the project?*

Estimated Cost of Project (Please provide a breakdown of the total cost of your project)*:

VAT (if applicable):

Total estimated cost of project*:

Funding of project (Please indicate how your organisation plans to fund the project)

Funds immediately available from your organisation*:

Funds that you intend to raise yourself from events:

Grants or loans applied for / confirmed from other organisations:

Grants requested from Berkhamsted Town Council:

Total funding of project*:

Please give details of any reserves or savings held by your organisation:

Who should cheque be made payable to?*

Documents to send with your application

Audited or independently examined accounts:

Balance sheet for the past financial year:

Bank statement:

Bank reconciliation as at the last balance sheet date:

UP-TO-DATE statements of any investment accounts:

Reset

DOCUMENTS TO SEND WITH YOUR APPLICATION

The following documents must be submitted with your application:

1. A copy of your organisation's audited or independently examined accounts including balance sheet for the past financial year, copy bank statement and bank reconciliation as at the last balance sheet date.

2. UP-TO-DATE statements of any investment accounts.

Please note: the payment of a grant by the Town Council is made strictly on the understanding that should the project not go ahead, all monies will be returned to the Town Council.